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This month, the information is regarding Nalfurafine hydrochloride. Pruritus is a common symptom seen in up to 90% of uremic patients, especially those with chronic renal failure requiring hemodialysis. The cause and mechanism of induction of pruritus are not known. Research and studies have revealed that an imbalance in the endogenous opioid system may be responsible for pruritus, with particular involvement of the kappa opioid system. The existing kappa opioid receptor agonists lack morphine-like adverse effects and are associated with dysphoria and psychotomimetic alterations. Thus, research efforts continue to focus on new kappa opioid agonists with novel structures to circumvent unwanted adverse effects.
Nalfurafine hydrochloride is a novel kappa opioid receptor agonist that is highly selective for the kappa opioid receptor in vitro and displays potent antipruritic activity in vivo. A single dose of an oral formulation was shown to alleviate itch in hemodialysis patients suffering from severe pruritus. The kappa-opioid agonist nalfurafine hydrochloride (Remitch®) was approved and launched for the first time in spring 2009 in Japan, where it is indicated for the improvement of pruritus in hemodialysis patients who have not responded to conventional treatment. Nalfurafine was codeveloped by Toray, Japan Tobacco and Torii Pharmaceuticals; it is manufactured and marketed by Toray. It has orphan drug status in Japan for the approved indication.
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